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Hollywood schizophrenia

BMJ 2006; 333 doi: (Published 01 September 2006) Cite this as: BMJ 2006;333:0609346
  1. Alison Smith, fourth year medical student1,
  2. Stephen J Cooper, senior lecturer2
  1. 1Queen's University Belfast
  2. 2Department of Mental Health, Queen's University Belfast

The portrayal of mental disorders in Hollywood movies has a considerable negative impact on public understanding, argue Alison Smith and Stephen J Cooper

Our culture is full of fictional portrayals of mental illness, and cinema has become fascinated with one condition in particular. A huge number of Hollywood blockbusters centre around a violent sociopath with a split personality who, in many cases, is labelled schizophrenic. Vague implications of mental illness in characters can be found in some of the most high profile pieces of cinema. In the Star Wars trilogy, Anakin Skywalker undergoes a personality flip to become the evil Darth Vader, as a result of a traumatic event in his life revealed in parts by the series of movies. In The Lord of the Rings, Gollum bickers with his alter ego Sméagol, apparently driven to madness and ugliness by dark forces associated with the ring he calls his “precious.” Beyond the world of fantasy films, however, Hollywood tends to use the schizophrenic tag directly, often in an inaccurate and stigmatising way.


The split personality is born

Alfred Hitchcock's classic 1960 thriller Psycho stars another dangerous character with dual personality. The seemingly harmless Norman Bates takes on the persona of his dead mother when committing murder, his psychosis supposedly triggered by the stress of her death. As the fictional psychiatrist Dr Fred Richmond attempts to explain, “When the mind houses two personalities, there is always a conflict, a battle...” It seems to be during Hitchcock's era that Hollywood schizophrenia was born, the symptoms of which are a split personality and tendencies towards evil, homicide, and genius.

Ironically, none of these are symptoms of real life schizophrenia. Split personalities are associated with a separate illness - multiple personality or dissociative identity disorder - and violence is not generally related to either condition. Although patients …

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